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Year in Review 2016-2017

Moving ahead in our journey of campassionate care

Every year we take pride in advancing our vision of providing the best ambulatory care possible for patients and families. In 2016-2017, however, we took a truly bold and historic step in that journey by deciding to integrate our operations with Kingston General Hospital to create a new academic health sciences centre. It is a step that will transform acute health care in our region.

Guided by the Board of Directors at each organization, the decision was the next logical move in an evolving partnership between our hospitals, which already had a 20-year history of shared programs, services and staff. We’re certain that integration will only create a stronger health system as we use our collective resources to better identify and seize opportunities to transform the patient experience.

Equally important to our decision—indeed, at the heart of it—was a commitment to retaining the Roman Catholic identity and mission of Hotel Dieu Hospital while also respecting the secular mission of Kingston General Hospital.

As busy as we were preparing for integration this year, we continued leading the way in ambulatory health care. Our patients and families remained at the core of successes such as bringing weight loss surgery under our roof to provide the full continuum of bariatric care, expanding chronic pain services to better equip patients to manage their pain and introducing a new breast reconstruction surgery program.

We also piloted or launched new ways for patients to manage chronic disease and access hospital specialists. With these innovations and others spotlighted in our Year in Review we continued to meet the growing health care needs of people in our region, while still finding savings to ensure a balanced budget.

In the midst of all the activity in this milestone year, we were inspired and strengthened by the commitment of our leaders, physicians, staff, learners and volunteers. In a new hospital-wide assessment of how we live our mission and values in the workplace they told us that they were proud of the powerful sense of family at Hotel Dieu Hospital. That sense of togetherness will carry us forward into the next stage of our journey of providing compassionate care.

Creating the new Kingston Health Sciences Centre

Hotel Dieu Hospital (HDH) and Kingston General Hospital (KGH) may have distinct histories and cultures, but one thing the people of both hospitals have always shared is a commitment to serve patients and families by providing them with the best care possible.

Over the years, it is this shared purpose that has seen our two organizations develop distinct roles in our regional health-care system. KGH is the region’s largest complex-acute and specialty care hospital while HDH is the leading acute-ambulatory care centre. By working together, we were able to create a system that made good use our precious resources and also made the most sense for our patients and many stakeholders.

But given the challenges of our current health-care system, where new funding is often hard to come by and the demands for our services keep growing, the time was right for both organizations to take our partnership to the next level – by integrating and creating a new Kingston Health Sciences Centre (KHSC).

From the start, we knew this new organization needed to have one Board of Directors, Chief Executive Officer and Executive Team, along with one budget and corporate strategy. It also had to honour the unique missions and cultures of both sites.

With these requirements in mind, the real work began of designing our new organization. To make sure we were taking everything into account, we reached out to people both inside and outside of our hospitals to find out what they wanted to see come to life in a new KHSC.

Creating the new KHSC: A timeline

After months of integration discussions by our two boards, it was over to HDH Board Chair Michael Hickey and KGH Board Chair George Thomson to share the big news at a media conference on June 28, 2016.

News of our pending integration was top of mind for staff, physicians and volunteers at both hospitals and shortly after the public announcement, communications were put in place to update everyone and to answer as many questions as possible. For starters, HDH CEO David Pichora and interim CEO Jim Flett and held a series of town halls for staff, while teams across the hospital were set up to have integration input discussions during their regular meetings.

To ensure we were designing a KHSC that everyone could be proud of, we also wanted to hear more from people in the community about our integration plans. We held a telephone survey to gather opinions from 1,000 people in Kingston and across the entire region. People could also fill out an online version. The survey revealed people strongly supported our integration and understood the top reasons behind it.

As part of integration, people at both hospitals were going to be asked to work together in new ways. To help prepare everyone for these types of changes, a special Change Day was held where leaders from both organizations came together to learn a common change management approach to help create a smooth transition to the new KHSC.

HDH and KGH aren’t the first two hospitals to integrate their operations. To help us navigate the process, we invited an expert panel of advisors to visit Kingston to share their knowledge and experiences with us. One of the key things we learned was the importance of keeping our existing hospital site names so patient and families know where to go for the care they need.

After a careful review of our integration submission, Minister of Health and Long-Term Care Dr. Eric Hoskins wrote to approve our plans and also to congratulate us for the leadership we are showing and the big contribution we are making to health system integration and transformation.

Along with getting all the behind-the-scenes legal work done, another priority was choosing a name for our new organization. Once again, we held a survey for people inside and outside the hospital to contribute their opinions. As a result of this process, we were able to decide on Kingston Health Sciences Centre as our new legal name. In June 2017 it became our public-facing brand name as well.

After all the legal documents were signed, sealed and delivered it was time for a special event to mark the official creation of Kingston Health Sciences Centre. Staff and patient experience advisors from both hospitals met in City Park to celebrate and unveil a commemorative plaque to mark the location of an Autumn Blaze maple planted in the late spring.

Transforming ambulatory health care

In September 2016, we ramped up our bariatric services, adding a surgical component that brings the gold standard of weight loss surgery closer to home for obese patients in our region. Now they can receive the full continuum of care—pre-surgical assessment, surgery and post-surgical follow-up—through a single team and in a single centre. Bringing bariatric surgery under our roof also made us the province’s seventh Bariatric Centre of Excellence.

A new clinical program is music to the ears of people with hearing loss who cannot be treated with regular hearing aids. Instead, a bone anchored hearing aid (BAHA) is connected to a titanium implant in the skull, where it conducts sound directly to the inner ear through an externally-placed sound processor. The hospital’s first BAHA recipient, who reports that his previously muffled hearing is now excellent, has declared the technology “very cool.”

Thanks to new funding, the chronic pain clinic continues to expand, with a stronger focus on helping patients understand their health care path. This year, a new self-management program was launched to decrease wait times, equip patients to better manage their pain and speed up their discharge back to community supports. Patient satisfaction with the clinic remains very high, with 86 per cent of patients responding positively when asked if the clinic is doing everything it can to understand their pain and to help them to live with it.

We tackled escalating patient volumes in cataract surgery by shifting the procedure from a main OR to a specialized surgery suite that accommodates the cataract surgery plus pre- and post-procedure steps. Now, instead of booking a dozen cataract cases each day we can book up to 20. At the same time we demonstrated the value of optimal OR design, and freed up an OR for our new bariatric surgery program.

A new pilot clinic for patients living with chronic disease is working to reduce the person’s length of stay in our Urgent Care Centre or an Emergency Department, and to eliminate the need for admission or repeat visits. After referral by a physician, patients are assessed by a Nurse Practitioner who follows up within 24 to 72 hours and in further clinic visits over three weeks.

Hospital physicians are helping patients and primary care providers access specialized care faster in a six-month eConsult pilot project underway until July 31, 2017. In an eConsult, a family physician queries a specialist about a patient via a secure, web-based platform. The specialist responds within 48 to 72 hours, reducing the need for face-to-face consults. Close to 200 e-Consults have been done, most often in dermatology, cardiology and gastroenterology.

In March our ophthalmology team welcomed more than 100 refugee families in our community to a one-day vision screening blitz. Recognizing that it can be very challenging to navigate a new city when you don’t know the language and might also have vision difficulties, the team was keen to identify and treat eye conditions that could prevent the newcomers from fully succeeding in their lives here.

improving the patient and family care experience

We introduced a new translation service this year that provides us with rapid 24-hour telephone access to 100 languages. Whether here for a hospital visit or speaking on the phone, patients can communicate with their care team and be sure they are getting clear, safe and accurate information to help them understand their illness, treatment and follow-up.

Patients are moving more smoothly and comfortably through the triage process in our Urgent Care Centre after renovations to reconfigure the space and improve sight lines. During the project, our Volunteers trialed a new ambassador role in Urgent Care, with 14 specially-trained Volunteers stepping up to help people with information, wayfinding and emotional support.

Making information available in the best way possible led to a major revamp of our patient education brochures this year. We translated more than 100 brochures into French, and also re-formatted them to make them accessible to people with disabilities, for example, making them readable by a screen reader and creating large-print versions.

Patients and families continue to provide valuable feedback in point-of-care surveys completed immediately after their clinic or lab visit. Almost 70 per cent of patients and families invited to complete a survey did so, rating their quality of care positively, indicating they are treated with dignity and respect and saying they were satisfied with the information they received prior to and during their clinic visit.

Supporting world-class research

As a member of the Council of Academic Hospitals of Ontario (CAHO) we proudly turned the spotlight on our research labs and clinician researchers this year when CAHO hosted a social media tour of Kingston hospitals and Queen’s University. HDH provided a behind-the-scenes look at research initiatives aimed at providing better outcomes in breast cancer surgery, helping our bodies move better and changing the quality of life for people living with neurological diseases.

Construction wrapped up on the new High-Speed Skeletal Imaging Lab, one of the few facilities in the world that can directly measure the human skeleton in motion. With data collection soon underway, the lab will be developing treatments and preventative strategies tailored to individual patients. It augments two adjacent Queen’s University labs—the Human Mobility Research Lab and Neuroscience Clinical Lab—and also brings researchers and hospital physicians together more quickly for better patient outcomes.

Creating a positive work culture

In our latest employee experience survey, staff reported feeling engaged and satisfied in the workplace, with 80.2 per cent of respondents citing a positive employee experience. We also scored significantly higher than 43 other provincial hospitals when it came to taking pride in our organization, sharing its values and rating our hospital an excellent place to work.

A hospital-wide assessment of how we live our mission and values in the workplace revealed a powerful sense of family at Hotel Dieu. The new Values Integration Assessment Process—a combination of survey, focus groups, tours and interviews—demonstrated to assessors from Catholic Health International that we enjoy a closely-knit workplace due to a strong emphasis on holistic care, the active presence of spiritual care services, mutual trust and respect among staff, trusted communications and positive community relationships.

Finding the best ways to lead in a faith-based organization is at the heart of a Catholic leadership program that our leaders and staff continue to attend as a means of understanding their roles and responsibilities in a Catholic health care organization. Sixteen of our managers, directors and senior executives have completed the intensive retreat program that gives people the time, space and opportunity to better understand themselves and their call to lead within Catholic health care.

Our culture is also defined by extending our mission of compassionate care into the community. At the annual We Walk for Comfort and Care, we helped to raise more than $34,000 for patient needs and comforts. When temperatures dropped, we collected and distributed more than 1000 warm coats to about 600 people during our Coat Drive, and we teamed up with our community to collect 50,000 pounds of food for the Partners in Mission Food Bank.

With the introduction of the new Exceptional Healer Award, patients and families had an opportunity to celebrate the physicians who provide their care. Spearheaded by our Patient & Family Council, the award sparked 20 nominations in which patients explained how their doctor consistently demonstrates the core concepts of Patient and Family-Centre Care: dignity and respect, information sharing, participation and collaboration with patients and families.

Our culture is also defined by extending our mission of compassionate care into the community. At the annual We Walk for Comfort and Care, we helped to raise more than $34,000 for patient needs and comforts. When temperatures dropped, we collected and distributed more than 1000 warm coats to about 600 people during our Coat Drive, and we teamed up with our community to collect 50,000 pounds of food for the Partners in Mission Food Bank.

Investing in information technology

This year we are flipping the switch on a new WiFi network, welcome news for patients, families and visitors who want to jump online and for clinical and administrative staff who want to work smarter and faster on medical devices, tablets, laptops and smartphones. It also translates into increased access to online education resources for learners just as a new competency-based medical education system at Queen’s University goes online in July 2017.

Having vital health care information available anywhere, anytime translates into faster, more informed health care. We moved a step closer to a shared electronic health record by continuing with the ConnectingOntario project, which had us contributing data to a provincial repository and adopting technology that lets us view patient data. Ultimately, the project will enable information sharing whether the patient is receiving care in a doctor’s office, community clinic or hospital.

Looking to the future

Across Ontario, these are challenging times for many hospitals. More people than ever are arriving at already busy emergency departments and many of them are in need of treatment for chronic diseases that require intensive care over long periods of time. Hospitals are also under pressure to provide new treatments and better patient care than ever before, with fewer available dollars.

It’s why we know our integration to create the Kingston Health Sciences Centre will set us up to meet many of these challenges in the years ahead.

Now that the new legal entity is in place, over the next year we will be turning our focus to fully integrating all of our programs, departments and services. As part of this exciting work we will be looking for ways to innovate and invest in new initiatives for the benefit of our patients and families.

We will also be developing a new vision, mission and longer-term strategy for KHSC. Along with this we will examine our overall brand along the way to make sure it reflects everything we stand for as an organization.

But we can’t do all of this work alone and over the next year we will be turning to the community for guidance and input on what we need to do next to help us transform care together. Stay tuned for more information on how you can be involved.